Infection remains one of the biggest challenges in treating battlefield injuries, particularly as antibiotic resistance continues to rise. LightOx is developing LXD231, a groundbreaking light-activated wound care treatment that rapidly kills harmful bacteria without relying on traditional antibiotics. Originally designed for use in hospitals and at home, the technology is now being explored for its potential to improve the treatment of traumatic injuries in conflict zones such as Ukraine.
Dr Sam Whitehouse, CEO of LightOx, explains how insights gained from visiting medica in Ukraine are helping to shape the development of the treatment and its potential role in both military and civilian healthcare settings.
How the treatment works
LightOx developed LXD231 as a treatment to kill bacteria in wounds. In simple terms, the compound is applied directly to the wound and then activated using a specific wavelength of light. Once activated, it rapidly destroys harmful bacteria, helping to prevent infection and support the healing process.
Unlike traditional antibiotics, LXD231 works only where it is needed. Rather than being taken orally or intravenously and affecting bacteria throughout the body, it is applied directly to the wound, targeting the infection at its source. Crucially, it is not vulnerable to microbial resistance, meaning it can be used to tackle antibiotic-resistant bacteria, which is an increasing concern in hospitals, communities and conflict zones around the world.
One of the important things about this treatment is that it’s really simple to apply. It can be used in a medical setting, people can apply it themselves at home, and it can be used on the battlefield through self-administration. This can be lifesaving, particularly for soldiers who may be stuck in remote locations or settings where access medical care is complicated and extraction is not possible. With untreated wounds leading to serious complications including infection, sepsis, amputation and death.
Part of NATO’s Defence Innovation Accelerator programme
LightOx is also privileged to be one of only two UK medical companies selected to join NATO’s Defence Innovation Accelerator (DIANA) programme this year, chosen from around 3,500 applicants worldwide. The programme is helping accelerate the development of LXD231 so it can be evaluated for use in military environments.
Unlike traditional drug development pathways, innovation in defence is moving at a much faster pace because of the urgent need to address challenges faced by armed forces. Technologies can be assessed and deployed in military settings before full regulatory approval, with the resulting data helping inform decisions about their future use in civilian healthcare. The balance of need and the risk is always the regulators area of expertise, but this quite clearly shifts in a time of war, and the need to keep people alive in extreme circumstances is shifted dramatically.
As part of the DIANA programme, LightOx is also working with other NATO allies and their military field evaluation teams to asses LXD231, providing valuable insight into how the treatment could be used in real-world operational environments away from the frontline.
The opportunity has also opened up many discussions including one most recently with the UK Government. I was invited to visit the House of Commons to discuss the role innovative technologies can play in supporting national defence. Defence is a high priority area, and with technology shifting so quickly, we need to make sure we’re protecting ourselves against emerging threats and adversaries who are advancing innovative technologies rapidly. Companies like LightOx have an important role to play in developing solutions, but innovation can only succeed when there is a strong two-way dialogue between those creating new technologies and those operating on the front line. Collaboration is key – without which we’re not going to keep up.
Meeting an urgent need in Ukraine
One of the lessons from COVID-19 was just how quickly the regulatory environment can adapt when there is an urgent and unmet need. And few situations demonstrate that more clearly than the war in Ukraine.
To better understand the challenges faced by frontline medical teams, I visited Lviv and Kyiv and spoke with hospital clinicians, special forces personnel and field medics. Those conversations provided invaluable insight into the realities of treating traumatic injuries in conflict zones and helped us assess how LXD231 could be used in real-world battlefield conditions, where rapid, effective treatment can make a critical difference.
We learnt that 87% of all wounds in Ukraine are blast injuries. People often have multiple injury sites, that can become multiple infection sites, and because they’re in an environment where there’s dirt, a lack of water, it’s difficult to clean and sterilise wounds. Which is when infections can become catastrophic.
Drug resistance is another major challenge, particularly with bacteria such as Klebsiella, which is becoming increasingly difficult to treat. In a conflict environment, that risk extends far beyond the individual patient. An infected wound can expose medics and other personnel to drug-resistant bacteria, creating opportunities for transmission. And if those infections spread beyond the battlefield and into the civilian population, what begins as a localised healthcare issue can quickly become a much broader global concern.
What we learned in Ukraine has also influenced how the treatment is packaged and deployed. The aim being to ensure it can be carried easily as part of a soldier’s individual first aid kit, with lightweight, durable packaging designed to withstand challenging conditions.
We’ve also carefully considered the volume of treatment required. It needs to be sufficient to effectively sterilise a wound and allow for repeat applications if evacuation is delayed, while remaining compact and light enough to be carried alongside other essential equipment. Every aspect of the product has been shaped by the practical realities of frontline care.
What excites me most about the potential of this treatment is being able to help so many people across the globe. When we visited Ukraine, it was clear just how urgent the need is for new approaches to wound care. What also stood out was the extraordinary resilience and ingenuity of the people working on the frontline. There was a genuine appetite for innovation, with clinicians and military personnel keen to understand how the treatment works and explore its potential to improve patient outcomes.
In the Western world, there is a risk that we become desensitised to the reality of this conflict. Every day, people are still being injured and losing their lives – ordinary men and women whose lives have been transformed by war and who are fighting to protect their country, their families and their future. We must never lose sight of that human cost. If there is an opportunity to accelerate the development of treatments that can reduce suffering, improve outcomes and ultimately save lives, then we have a responsibility to pursue it.
